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Monday, July 27, 2009

Over the years, I have learned a lot from listening to thoughtful conservatives who are active in the health care area. Mark Litow, a formal co-worker and partner from my consulting firm days always had thoughtful rationales for his policy positions. Although I usually disagreed with Mark's positions, I learned a lot from his thoughtful approach to big questions. We had several excellent informal discussions over lunch. Two of the traditional Conservative precepts that I accept are;

(1) Government is pretty much limited in what it can provide. Government cannot be all things to all people, since Government, when looked at from the Economic perspective, is little more than a wealth transfer mechanism. This is especially important to remember when a majority households are feeling either unwilling or unable to "pony up" additional tax monies.

(2) Personal accountability matters, although this is of limited relevance in health care. We all make suboptimal decisions when we are immunized from the consequences of our decisions. Simply stated, a party where each person pays $10 for a plastic cup and the right to unlimited beer will be very different from a party where each person must pay for each glass of beer. That said, the highest stakes (both economic and personal) health care decisions we make in our lives are most often made when we feel we have little choice in the matter. From my own experience, when a doctor finds a potentially deadly tumor and recommends removal the next week, most patients will not want to take a month or two to find a more efficient provider of that service, meet the new provider, redo all the preliminaries, and save themselves a few thousand dollars and save their health plan possibly hundreds of thousands. I've been there, and I can tell you, it ain't happening.

All that said, I am disappointed that I haven't heard a lot of thoughtful Conservative thinking expressed on this issue lately. This video sums up about everything I've heard.